Individual
ROBERTA GRAY STAIGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSSW, LISW
Contact information
Practice address
922 W RIVERVIEW AVE, DAYTON, OH 45402-6424
(937) 296-1007
Mailing address
922 W RIVERVIEW AVE, DAYTON, OH 45402-6424
(937) 296-1007
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
I0002143
OH
101YM0800X
Mental Health Counselor
I0002143
OH
101YP2500X
Professional Counselor
I0002143
OH
106H00000X
Marriage & Family Therapist
I0002143
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000284606
ANTHEM
OH
01
—
291993
MANAGED HEALTH NETWORK
OH
01
—
62-20934
UNITED BEHAVIORAL HEALTH
OH
Enumeration date
03/13/2008
Last updated
03/13/2008
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